Puzzling Out 10 Alzheimer's Myths

May 29, 2009

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Many over-the-counter pain relievers -- belonging to a class known as non-steroidal anti-inflammatory drugs, or NSAIDs (drugs including acetaminophen and ibuprofen) -- have been said to either increase or decrease the likelihood of developing dementia or Alzheimer's disease.

Major studies, however, have disagreed over the result of using NSAIDs to ward off or delay Alzheimer's, which has left doctors recommending using them for pain relief, but not for assisting with Alzheimer's.

At this point, the decision to use these drugs may have nothing to do with Alzheimer's.

"You should take them for reasons that have nothing to do with Alzheimer's disease and dementia," said Karlawish.

Lyketsos of Johns Hopkins has looked at the issue and said that part of the complication may lie in the fact that these drugs might have differing effects at different stages of the disease.

"I think it's an unsorted question," said Lyketsos.

Part of the problem, he explained, is that there's not yet an explanation for why NSAIDs would affect Alzheimer's.

"We're not entirely sure what mechanism these drugs might have aside from being anti-inflammatory," said Lyketsos.

It may be that drugs affect a person based on where they are in their Alzheimer's progression. At this point, he said, the suggestion is that people who have symptoms have no benefit or perhaps some harm from taking NSAIDs.

Meanwhile, he said, studies of patients who have developed nothing seem to show some benefit.

"They suggest that people who take NSAIDs are less likely to get Alzheimer's. They have to be taking these NSAIDs long before these symptoms occur," said Lyketsos.

Patients may be harmed or helped by taking anti-inflammatories, depending where in the disease progression they are. However, even if these drugs might help protect certain patients, tests have not yet been developed that would help doctors identify them.

"Right now, it's hard to know who those people are," said Lyketsos.

Fact or Myth? The artificial sweetener aspartame can cause Alzheimer's.

Answer: Almost definitely a myth

Aspartame and other artificial sweeteners have been accused over the years of causing a number of diseases, including brain tumors, Parkinson's, multiple sclerosis and Alzheimer's.

But there has been little to no evidence to back up these claims, or even enough to warrant looking into them

"I have not seen studies that would lead me to suggest that the FDA should review aspartame and its safety with respect to ... Alzheimer's disease," said Karlawish.

Small said that excessive consumption of artificial sweeteners should be avoided for other health reasons, but not a fear of Alzheimer's.

"We don't have any direct epidemiological evidence to support that," he said.

Advising taking everything in moderation, Small said, "I minimize my brain and body exposure, just in case there is a problem."

While it is difficult to declare this one a myth without a long-term trial, evidence to suggest any truth behind it is sorely lacking.